title: Concomitant tuberculosis and pyogenic infection of the cervical spine. A case report.
abstract: METHODS
  This case report describes a middle-aged woman with concomitant tuberculosis and pyogenic infection of the cervical spine.
  
  
  OBJECTIVE
  To describe an unusual case of concomitant tuberculosis and pyogenic infection of the cervical spine.
  
  
  BACKGROUND
  Neither tuberculosis nor pyogenic spondylitis of the cervical spine is a common disorder. This case report describes a concomitant infection of C3-C4 in an otherwise healthy patient. To the authors' knowledge, such a case has never been reported.
  
  
  METHODS
  This 52-year-old woman had spontaneous neck pain and myelopathy. Radiologic examination revealed the presence of an epidural abscess with destruction of C3-C4 vertebral bodies.
  
  
  RESULTS
  Anterior decompression and fusion were performed, followed by therapy with antituberculosis drugs and antibiotics. The patient completely recovered. A follow-up radiograph revealed that solid fusion had been achieved.
  
  
  CONCLUSIONS
  A case of concomitant tuberculosis and pyogenic infection of the cervical spine is presented. The possibility of this differential diagnosis should be considered, especially in areas of endemic tuberculosis. Examination of biopsy samples for histologic and bacteriologic findings is important to confirm this diagnosis. Radical debridement and combination therapy are strongly recommended to treat patients with this combination of infections.
authors.affiliation: Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: W K
authors.initials: WK
authors.lastname: Fu
authors.forename: W C
authors.initials: WC
authors.lastname: Wu
authors.forename: F K
authors.initials: FK
authors.lastname: Ip
mesh_terms: D000038:Abscess / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009336:Necrosis; D013117:Spinal Cord Compression / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D013166:Spondylitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology